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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although there is a strong relationship between emotional and external eating, separate subscales for these behaviors have been constructed in the Dutch Eating Behavior Questionnaire. This study tries to establish whether this distinction is justified. We studied relationships among self-reported ( 1) degree of emotional and external eating behavior and (2) problems with (a) emotional distress and relationships, (b) stimulus-boundness (inappropriate amounts of either too much or too little exercise, work, leisure activities, and spending money), and (c) problems with substance use (alcohol, illicit drugs, nicotine, or caffeine) in a sample of female students. No relationships were found between either type of eating behavior and problems with substance use. Furthermore, the significant relationship between emotional and external eating behavior and stimulus-boundness disappeared in the subsample who had problems with overeating. The fact that in all samples emotional eating was significantly related to problems with emotional distress and relationships (anxiety, depression, phobias, suicidal acts or ideations, intimate relations, and sexual contacts) but external eating was not, suggests that the two types of eating behaviors refer to independent constructs. Thus, the use of separate scales to measure these theoretically different aspects of overeating seems warranted.
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PMID:On the relationship between emotional and external eating behavior. 871 56

The present study describes the relationship between depression and several measures of social functioning--including employment, criminal activity, incarceration, marital functioning, and alcohol and drug use--in a population of adult drug abusers. Our investigation extends past work in this area by specifically investigating the effects of depression (as opposed to simple substance use) on social and interpersonal functioning. Predictably, elevated levels of depression were associated with increased use of hard drugs and alcohol, greater levels of institutionalization, reduced attendance at work or school, and lower overall rates of marital satisfaction. Consistent with previous reports, level of marijuana use was not related to severity of depression. It appears that depressed substance abusers experience significantly more social, vocational, and interpersonal dysfunction than their nondepressed counterparts. It is proposed that the efficacy of existing treatment programs for adult drug abusers will be enhanced through the addition of strategies to assess and ameliorate depression.
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PMID:Relationship of depression with measures of social functioning in adult drug abusers. 873 May 23

The diagnosis of depression has been viewed as an important factor in the treatment response for those who have alcohol and other drug dependence. The objective of the study was to examine the prevalence of a lifetime history of major depression in inpatients with a substance use disorder in addictions treatment. An evaluation study of 6,355 patients was conducted in inpatient and outpatient addictions treatment programs from 41 sites. Subjects were required to have a substance use disorder and to be evaluated for a lifetime diagnosis of major depression according to DSM-III-R criteria. The rate of a lifetime diagnosis of major depression was 43.7%. The most common diagnosis was alcohol dependence, followed by cocaine dependence, and cannabis dependence). Depression was associated in significantly greater numbers with diagnoses involving drugs other than alcohol, in females greater than in males, with number and frequency of use, and in inpatient programs more than outpatient programs. The rates for continuous abstinence at one year did not differ between those with and without a lifetime history of depression.
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PMID:Prevalence of depression and alcohol and other drug dependence in addictions treatment populations. 881 80

General principles for treatment-resistant psychiatric disorders include reevaluation of diagnosis, search for hidden comorbidity, and systematic trials of alternative treatments and treatment combinations. For the combination of refractory depression and substance abuse, alternative approaches to both problems need to be tried, as suggested in the decision tree in Figure 1. Recognition of a previously unappreciated substance abuse problem or institution of more effective substance abuse treatment (see Table 2) can improve the outcome of depression. Hospitalization is often useful to enforce abstinence and to clarify the diagnosis of depression, and is particularly indicated if substance abuse is severe. If hospitalization is not possible then features of the history, such as relative onsets of depression and substance abuse, can be considered to support the diagnosis. TCAs and SSRIs have been studied in depressed substance abusers and should be the first lines of treatment. If these fail, other medications, medication combinations, or ECT should be considered, extrapolating from the general literature on treatment of refractory depression. In general, single agents should be preferred to combinations, as this reduces the odds of drug-drug interactions in patients who may abuse a variety of substances. Impairment by antidepressant agents of hepatic metabolism of other drugs should be considered, and sertraline, for example, might be preferred over fluoxetine for this reason. For each case, the known side effects and risks of a given antidepressant medication must be considered in the context of a patient's substance abuse pattern and medical problems. Such risk:benefit analyses are often difficult, as illustrated in the cases presented. Finally, although it is a rare occurrence, antidepressant medications that are anticholinergic or amphetamine-like may be abused, and this needs to be monitored. Alcohol or drug abuse history is a likely risk factor for benzodiazepine abuse, and benzodiazepines should, therefore, be avoided or used with caution. These recommendations for management of treatment-resistant depression with substance abuse are based upon clinical experience and extrapolation from the literature on treatment-resistant depression, treatment of substance abuse, and initial treatment of depression in substance abusers with TCAs and SSRIs. More treatment research is needed, particularly on Type IV patients where both depression and substance use are treatment resistant.
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PMID:The management of treatment resistance in depressed patients with substance use disorders. 882 92

This study examines the psychosocial problems of spouses bereaved as a consequence of unnatural causes of death (suicide and traffic fatality) in two countries, Slovenia (n = 53) and The Netherlands (n = 32). Structured interviews consisted of standardized measures for depression, substance use, social reactions, and acceptance and attribution of the loss. Although marked differences in sociodemographic background exist, bereaved subjects from both countries show more similarities than differences. Depressed symptomatology is slightly higher in the Slovene bereaved, but symptom patterns are almost identical. Core indicators of clinical depression, as well as reported substance use, are equally low in both countries, and gender and mode of death do not differ significantly. Social acceptance is more problematic in suicide bereaved, particularly in Slovenia. Methodological considerations of cross-cultural bereavement studies are discussed.
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PMID:Psychosocial impact of bereavement after suicide and fatal traffic accident: a comparative two-country study. 884 75

The associations between early onset (prior to 15 years of age) cannabis use and rates of mental health or adjustment problems during the period from 15 to 16 years of age were studied in a New Zealand birth cohort. Early onset cannabis users were at increased risks of later substance use behaviors, conduct/oppositional disorders, juvenile offending, severe truancy, school dropout, anxiety, depression, and suicidal ideation. Early cannabis users had odds of these outcomes ranging from 2.7 to 30.8 times higher than the odds for those who did not use cannabis prior to age 15. Most of the elevated risks of early onset users were explained by the fact that they were a high-risk groups of adolescents characterized by family disadvantages, early adjustment problems, and high affiliations with substance-using or delinquent peers. Nonetheless, even after adjustment for a wide range of confounding factors, early onset users had increased risks of later cannabis use. It is concluded that while most of the elevated risks of early onset users were explained by social, family, and individual characteristics of this group, early onset users were at increased risks of later cannabis use.
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PMID:The short-term consequences of early onset cannabis use. 888 45

One hundred and eighty-three participants were divided into three groups containing: 61 cocaine-dependent; 59 polydrug-dependent; and 63 normal subjects. All were evaluated using a basic neuropsychological assessment battery. The dependent groups exhibited significantly lower scores on short-term memory, attention, and concept formation tests. Performance on some subtests correlated negatively with the length of dependency and frequency of substance use. As compared with the control group, the dependent groups exhibited significant differences in the following personal and family areas: (a) depression and anxiety traits; (b) self-aggression and lack of fear in childhood; (c) family history of substance dependency; and (d) difficulties with interpersonal relationships. The operation of predisposing developmental factors for substance dependence is suggested.
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PMID:Cognitive effects of cocaine and polydrug abuse. 892 91

A factor that has received little investigation concerns the feeling state of need fulfillment and how this may relate to the significant public health problem of adolescent substance use. A survey of 823 students was conducted at a suburban public high school in the Southeastern United States. The questionnaire contained a scale focusing on fulfillment of adolescent needs, the Children's Depression Inventory, and items on current substance use. The results of t-tests indicated that the higher the adolescent is on the Need scale, the greater the likelihood of engaging in substance use (p < .05). Further, results indicated that cigarette smoking, drinking alcohol, and smoking marijuana are associated with significantly higher scores on the Need scale for both males and females. Although the Need scale was significantly positively correlated with the Children's Depression Inventory (r = .45, p = .0001), the two feeling states were not collinear. However, the Need scale was not significantly correlated with age, indicating that the need state is not simply a developmental process (r = .04, p = .11). The results suggest that a feeling state of unfulfilled needs may propel adolescents into the destructive behavior of substance use. A state of high wants and needs that cannot be gratified simply in a complex society may be a precursor of substance use.
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PMID:Substance use among adolescents: fulfilling a need state. 897 Jun 55

Since health-risk behaviors are often encountered in clusters among adolescents, it was hypothesized that adolescents with poor school attendance would be associated with more health-risk behaviors (e.g., substance use, violence) than those who attend school regularly. This study assessed the relationship between poor school attendance and health-risk behaviors, and described health-risk behaviors and self-esteem among adolescents seeking employment. In this cross-sectional study, school attendance (poor vs. regular attendance) was related to health-risk behaviors by asking 122 subjects seen at a New York City Working Papers Clinic to complete both a 72-item questionnaire about their health-risk behaviors and the 58-item Coopersmith Self-Esteem School Form Inventory. Chi-square and Fisher's Exact Tests were performed. The poor and regular attenders of school differed significantly in only 5 out of 44 items pertaining to health-risk behaviors. Self-esteem measures for the two groups did not differ from one another or from national norms. In this sample, depression "in general" (global) and "at home," but not "at school," were associated significantly with suicidal thoughts/attempts and serious past life events (e.g. family conflict, sexual abuse). There were no significant associations between depression or self-esteem and illicit substance or alcohol use. We found few associations between poor school attendance and health-risk behaviors in this sample of employment-seeking adolescents. The poor and regular attenders of school were similar in most aspects of their health-risk behaviors and self-esteem.
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PMID:School attendance, health-risk behaviors, and self-esteem in adolescents applying for working papers. 898 20

This study examined the reliability, validity, and responsiveness of Lehman's Quality of Life Interview (QOLI) as an outcome measure on 981 acutely ill psychiatric inpatients assessed longitudinally at admission and discharge. Patients were stratified into five diagnostic (DX) (depressed bipolar, depressed unipolar, schizophrenia, mania, and other diagnoses) and two substance use disorder (SA) strata (with and without concurrent substance abuse/dependence) based on DSM-III-R criteria. There was good replication of the factor structure, excellent internal consistency, overall and within DX and SA groups. Intercorrelations showed that the functional and satisfaction indices measure unique aspects of the quality of life. The construct consistency of the QOLI was dependent upon psychiatric diagnosis and life domain. Intercorrelations of functional and satisfaction indices for patients with depression were greater than for manic patients. We demonstrated strong consistency of construct validity for family and social relation domains, but not safety or leisure activities. Construct validity was shown to hold longitudinally. Analyses of DX and SA group differences on satisfaction and functional indices of the 8 life domains supported discriminative validity: Depressed patients reported the most dissatisfaction, followed by schizophrenic patients, and manic patients reported the greatest satisfaction in most life domains. Patients with concurrent substance abuse generally reported less satisfaction and lower quality of life than patients without a dual diagnosis. Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes in global life, leisure activities, living situation, and social relations from hospital admission to discharge (an average of 2 weeks). This study supports the use of the QOLI as an outcome measure to assess quality of life in acutely ill hospitalized psychiatric patients.
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PMID:Longitudinal assessment of quality of life in acute psychiatric inpatients: reliability and validity. 909 98


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